MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other,user facility report with the FDA on 2019-04-15 for BD VACUTAINER? URINE COLLECTION CUPS 364975 manufactured by Becton, Dickinson & Co. (broken Bow).
[142044632]
Device expiration date: unknown. A device evaluation is anticipated, but has not yet begun. Upon completion of the investigation, a supplemental report will be filed. Device manufacture date: unknown.
Patient Sequence No: 1, Text Type: N, H10
[142044633]
Material no. 364975, batch no. Unknown. It was reported that after use of the bd vacutainer? Urine collection cups a child put a used urine lid in their mouth. The child opened a sharps container that was in a phlebotomy room that contained only urine cup lids and put the lid into their mouth. No harm was proven but they went to a different facility for testing of the child. The following information was provided by the initial reporter: child opened a sharps container that was in a phlebotomy room. Sharps container contained only urine cup lids (#364975). No lot# available. Child put the lid into their mouth.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1917413-2019-01179 |
| MDR Report Key | 8515484 |
| Report Source | OTHER,USER FACILITY |
| Date Received | 2019-04-15 |
| Date of Report | 2019-04-23 |
| Date of Event | 2019-03-22 |
| Date Mfgr Received | 2019-03-27 |
| Date Added to Maude | 2019-04-15 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | BDX BRETT WILKO |
| Manufacturer Street | 9450 SOUTH STATE STREET |
| Manufacturer City | SANDY UT 84070 |
| Manufacturer Country | US |
| Manufacturer Postal | 84070 |
| Manufacturer Phone | 8015652341 |
| Manufacturer G1 | BECTON, DICKINSON & CO. (BROKEN BOW) |
| Manufacturer Street | 150 SOUTH 1ST AVENUE |
| Manufacturer City | BROKEN BOW NE 68822 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 68822 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BD VACUTAINER? URINE COLLECTION CUPS |
| Generic Name | SPECIMEN TRANSPORT AND STORAGE CONTAINER |
| Product Code | KDT |
| Date Received | 2019-04-15 |
| Catalog Number | 364975 |
| Lot Number | UNKNOWN |
| Device Availability | * |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BECTON, DICKINSON & CO. (BROKEN BOW) |
| Manufacturer Address | 150 SOUTH 1ST AVENUE BROKEN BOW NE 68822 US 68822 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2019-04-15 |